Depression and Suicidal Ideation Among Patients With Cancer in the United States: A Population-Based Study

Abstract

PURPOSE: To evaluate the association between cancer diagnosis and depression and suicidal ideation in a population-based cohort in the United States. METHODS: This was a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) conducted for the years 2005 to 2016. Depression was assessed using a validated tool (Patient Health Questionnaire-9, and suicidal ideation was assessed by item number 9 of this tool. Propensity score matching was conducted to match survey respondents with cancer versus those without cancer. Multivariable logistic regression analysis was then conducted to evaluate factors associated with higher probability of depression and suicide among the whole postpropensity cohort. RESULTS: A total of 32,178 survey respondents were eligible and included in the study. These included 3,043 respondents with cancer and 29,675 respondents without cancer. Within the postpropensity cohort, a cancer diagnosis was not associated with a higher probability of depressive disorders (odds ratio, 0.937; 95% CI, 0.819 to 1.073), whereas it was associated with a higher probability of suicidal ideation (for respondents without cancer v those with cancer: odds ratio, 0.695; 95% CI, 0.517 to 0.935). CONCLUSION: Cancer diagnosis is associated with a higher probability of suicidal ideation. Screening for suicidal ideation should be part of the assessment of patients with cancer.